This is the first time developmental outcome following hearing screening in children with permanent childhood hearing impairment was studied in a unique, pseudo-randomized design. We found that... Show moreThis is the first time developmental outcome following hearing screening in children with permanent childhood hearing impairment was studied in a unique, pseudo-randomized design. We found that early detection of hearing loss by newborn hearing screening (and subsequent early intervention) is beneficial for the development of children with permanent childhood hearing impairment, although their development at 3-5 years is not yet comparable to that of children with normal hearing. We showed that the yield of the current hearing screening program is large, but that there is ample room for improvement in the timing following early detection of hearing loss. We would like to emphasize that the aetiology of permanent childhood hearing impairment should be investigated and the cause taken into account when evaluating the development of the child. Show less
This thesis describes the long-term consequences of growth hormone and insulin-like growth factor I excess in patients cured from acromegaly for a mean duration of 17 years. Regarding the... Show moreThis thesis describes the long-term consequences of growth hormone and insulin-like growth factor I excess in patients cured from acromegaly for a mean duration of 17 years. Regarding the considerable prevalence of diverse morbidity in these patients, during the active phase of the disease but even more so after 17 years of disease cure, we suggest the screening of acromegalic patients on highly frequent comorbidities, such as osteoarthritis, vertebral fractures, colonic polyps, and colonic diverticulae. It is of great concern to recognize the long-term consequences of the disease in order to offer the patients adequate follow-up and multidisciplinary care. The aim should be to control the persisting complex morbidity as much as possible in order to prevent the patients from a further decrease in quality of life. The patients__ physician as well as the patient itself should be aware of the long-term consequences of acromegaly in order to eliminate surreal expectations concerning recovery of certain comorbidities. Show less
Vestibular schwannomas are benign intracranial tumors which generally arise from the Schwann cells of the superior part of the vestibular portion of the eight cranial nerve. The most common... Show moreVestibular schwannomas are benign intracranial tumors which generally arise from the Schwann cells of the superior part of the vestibular portion of the eight cranial nerve. The most common symptoms accompanying vestibular schwannoma (VS) are unilateral hearing loss, tinnitus, vertigo and unsteadiness. For many years, microsurgical treatment of VS has been considered the __gold standard__. However, the treatment of VS continues to evolve with the advent of alternative treatment options such as wait and scan and stereotactic irradiation. Moreover, advances in MRI techniques have allowed for an early diagnosis and exact measurement of growth, which has led to an increased number of patients with small and minimally symptomatic tumors. As a result, the treatment of VS no longer involves life saving surgery, but prophylactic management of future morbidity. These developments have also created new insights into how vestibular schwannoma can be best treated, as it has become clear that the tumor may remain unchanged for many years. However, the treatment of VS patients still remains a matter of debate with advocates and opponents of each modality. Traditionally, the evaluation of VS treatment was performed using primary outcome measures such as mortality and morbidity. But the subject of quality of life (QoL) has increasingly become an important outcome measure in VS. QoL may provide clinicians valuable informati on that is not always Show less
